Prior authorization measure among week’s new bills
Some important health care bills that were introduced in the Georgia General Assembly this week include…
– S.B. 80, a bill by Sen. Kay Kirkpatrick, M.D. (R-Marietta) that would improve the prior authorization process in Georgia by 1) requiring insurers and PBMs to be more transparent about the prior authorization process and requiring them to notify the applicable stakeholders when they change their prior authorization process or requirements and 2) requiring prior authorization determinations and appeals decisions to be made by a physician who is in the same specialty and 3) requiring insurers to respond to prior authorization requests within two business days for non-urgent care and within 24 hours for urgent care and 4) preventing insurers and PBMs from revoking, denying, or changing a prior authorization approval for 45 days and requiring payment when a prior authorization is granted and 5) keeping prior authorization approvals for chronic/long-term care in place for one year. MAG supports this legislation, which was assigned to the Senate Insurance and Labor Committee.
– S.B. 82, a bill by Sen. Michelle Au, M.D. (D-Duluth) that would prohibit insurers from denying coverage for emergency care based solely on the final diagnosis. MAG supports this measure, which was assigned to the Senate Insurance and Labor Committee.
– S.B. 83, a bill by Sen. Sally Harrell (D-Atlanta) that would create a health insurance option for patients who are not eligible for Medicare, Medicaid or the PeachCare for Kids Program. MAG is reviewing this legislation, which was assigned to the Senate Appropriations Committee.
– H.B. 147, a bill by Rep. Heath Clark (R-Warner Robbins) that would allow health care licensure by endorsement for individuals who 1) hold a license to “practice such occupation or profession issued by another state that was acquired prior to moving from another state and establishing residency in this state for which the training, experience, and testing are substantially similar in qualifications and scope to the requirements under this state to obtain a license” and 2) are “in good standing in such other state” and 3) “passes any examination that may only be required to demonstrate knowledge of the laws and rules and regulations of this state specific to the practice of the profession, business, or trade for which such license by endorsement is being sought.” MAG is reviewing this legislation, which was assigned to the House Regulated Industries Committee. It is also worth noting that Sen. Bruce Thompson introduced a similar bill in the Senate (S.B. 45), which was referred to the Senate Regulated Industries and Utilities Committee.
– H.B. 163, a bill by Rep. Sharon Cooper (R-Marietta) that would require the Georgia Department of Community Health (DCH) to submit a plan to the U.S. Department of Health and Human Services (HHS) to get approval to implement an “express lane” enrollment feature for Medicaid and direct the Georgia Department of Human Services to automatically enroll and renew eligible children in Medicaid based on application data it receives for the Supplemental Nutrition Assistance Program. MAG supports this legislation, which was referred to the House Health and Human Services (HHS) Committee.
– H.B. 164, a bill by Rep. Demetrius Douglas (D-Stockbridge) that would require health insurers to provide their enrollees with no less than 80 percent of the prescription drug rebates that are related to the enrollee’s prescriptions that the insurer receives from third parties. MAG supports this legislation, which was referred to the House Special Committee on Access to Quality Health Care Committee.
– H.B. 213, a bill by Rep. Mary Robichaux (D-Roswell) that would repeal the state’s nurse protocol requirements and allow APRNs to practice on an independent basis, including writing prescriptions for Schedule II drugs. MAG opposes this bill, which was assigned to the House HHS Committee.
– H.B. 215, a bill by Rep. Robichaux that would require DCH to 1) make the telehealth options waivers that were established during the pandemic permanent and 2) create a system to certify, recertify, and train telehealth providers. MAG supports this legislation, which was assigned to the House HHS Committee.
– H.B. 234, a bill by Rep. Lee Hawkins (R-Gainesville) that would allow self-funded health care plans – which are exempt from state regulations as a result of federal law – to opt into Georgia’s Surprise Billing Consumer Protection Act (2020’s H.B. 888). MAG supports this legislation, which was referred to the House Special Committee on Access to Quality Health Care.
– H.B. 255, a bill by Rep. Scott Holcomb (D-Atlanta) that would 1) “provide for the retention of evidence of sexual assault when the victim chooses not to immediately report the assault and provide for a sexual assault case tracking system” and 2) “require law enforcement agencies to enter certain information into the Violent Criminal Apprehension Program established and maintained by the Federal Bureau of Investigation” and 3) “create the Forensic Medical Examination Advisory Committee to sexual assault nurse examiners as a condition for reimbursements” and 4) “require the Georgia Composite Medical Board to refuse, suspend, or revoke the license of a physician who has committed a sexual assault on a patient” and 5) “require mandatory reporting by health care professionals who have reasonable cause to believe that a physician has committed a sexual assault on a patient” and 6) “provide for annual reporting to the General Assembly of the number of physicians investigated or disciplined for the sexual assault of patients.” MAG is reviewing this legislation, which has been assigned to the House Judiciary Non-Civil Committee.
– H.B. 261, a bill by Rep. Todd Jones (R-Cumming) that would establish a pilot program to conduct a simulated exchange for health care facilities to purchase and sell charity care credits to meet their charity care requirements. MAG is reviewing this legislation, which has been assigned to the House Human Relations & Aging Committee.
– H.B. 268, a bill by Rep. Bill Werkheiser (R-Glennville) that would allow Georgia to participate in the Occupational Therapy Licensure Compact Act. MAG is reviewing this legislation, which has been assigned to the House Regulated Industries Committee.
– H.B. 271, a bill by Rep. Bert Reeves (R-Marietta) that would allow DCH to assess a fee on providers who operate ambulance services to obtain federal financial participation for Medicaid. MAG is reviewing this legislation, which has been assigned to the House HHS Committee.
– H.B. 290, a bill by Rep. Ed Setzler (R-Acworth) that would prohibit hospitals or nursing homes from instituting policies that limit a patient’s designated family members or friends from visiting them when they are hospitalized or being treated for more than 24 hours, including during a declared public health emergency. The legislation would allow facilities to establish reasonable safety requirements, although “at least two designated family members or friends [would be] authorized for visitation and visitation [would be] authorized for no less than two hours per day.” This measure also includes liability protections. MAG is reviewing the legislation, which has been assigned to the House Human Relations and Aging Committee.
